The Heareka method is a hearing aid fitting approach developed by audiologist Armaj Ali at BestHear in Swansea, Wales. It combines Real Ear Measurement (REM) — the objective clinical standard for verifying hearing aid amplification at the eardrum — with structured subjective fine-tuning based on the wearer’s lived experience in the room. Both halves are completed inside a single appointment.

The method was developed in response to a recurring clinical observation: a significant proportion of patients fitted by conventional protocols end up with their hearing aids unused in a drawer. Heareka’s working hypothesis is that the standard fitting protocol stops halfway — verifying delivery to the ear without verifying perceived experience. The method picks up where the standard stops.

The success of a Heareka fitting is defined by two patient-observable outcomes: the wearer forgets they are wearing the aids, and the people around them stop being reminded that the aids are needed. When both are true, the fitting has worked. When either is missing, the fitting continues.

1. Real Ear Measurement (REM). An objective clinical procedure where a thin probe microphone is placed near the eardrum to measure exactly what amplification the hearing aid is delivering, against the prescription target. REM is the gold-standard verification step in audiology and is widely considered the minimum bar for a competent fitting. Most commercial fittings use REM; many do not. Heareka assumes REM is non-negotiable.

2. Subjective fine-tuning of lived experience. A structured process of verifying the wearer’s experience of the amplified sound in real time — what they hear, how they hear it, how it compares to their pre-amplified state, where the sound feels uncomfortable or unnatural. This is not casual feedback; it is methodical interrogation of perception, anchored in a clinician’s full attention. The method developed it during a period when REM equipment was not available in the clinical setting; once REM became available again, the two halves were combined rather than the subjective work being abandoned.

Either half alone produces inconsistent outcomes. Combined inside a single appointment, with the screen and the chair feeding each other in real time, they produce the result Heareka is named for.

The HEAREKA moment is the point in the fitting at which the wearer reports that the hearing aid has stopped feeling like a hearing aid and started feeling like hearing. The room sounds like the room. Conversation sounds like conversation. The kettle, the cat, the grandchildren’s voices return in their natural relative volumes — not louder, not flattened, not metallic.

The first patient to undergo the combined-method fitting at BestHear in 2019 was so moved by the result that she made an unsolicited donation to the NHS in thanks. The combination has since been delivered to over a hundred patients across BestHear’s Swansea and Pontyclun clinics, with consistent results.

Heareka uses the CASE framework to organise the four dimensions a successful hearing aid fitting must address. The acronym stands for:

C — Comfort. The physical comfort of the device in or on the ear. If a hearing aid is uncomfortable, it gets taken out. The drawer pathway begins here.

A — Appearance. How the device looks to the wearer and to others. Patients report regularly that visible, conspicuous, or aesthetically poor devices contribute meaningfully to drawer outcomes.

S — Sound. The quality of the amplified sound experience. Not loudness — accuracy, naturalness, and lack of distortion. This is where the REM + subjective combination operates.

E — Ease of Use. Day-to-day operability. If the wearer cannot reliably use, charge, clean, or adjust their aids, even a perfect acoustic fit ends up in a drawer. Most settings the wearer might want to control are configured at the fitting to handle themselves automatically — fewer programmes, fewer manual adjustments, fewer reasons to disengage.

A Heareka fitting is not considered complete until all four CASE dimensions have been verified. Anything less, and the fitting continues.